Because of Corona: drug supplies are running low

There are already problems with the replenishment of some drugs: the spread of the coronavirus pathogen could pose a risk to the delivery of many important drugs and vaccines. Countermeasures are now being taken.

Confused patients who cannot get their medication at the pharmacy. Concerned doctors who have too few vaccines available – The corona pandemic is also affecting healthcare.

Some experts note that it has exacerbated bottlenecks in the delivery of some drugs and vaccines, including important ones. Medical President Klaus Reinhardt said the problem had “increased extremely” due to the pandemic with its trade restrictions. The manufacture of pharmaceutical products and active ingredients is specialized and globalized; For cost reasons, it is increasingly produced in China or India, for example, this is now proving to be a problem.

Pneumococcal vaccination was temporarily not possible

In spring, one was concerned about the shortage of central substances such as propofol for artificial respiration or the adrenaline needed in intensive medicine, as Reinhardt of the German Medical Association (BÄK) recently described in the “Tagesspiegel”. He warned: “If we run out of funds it would be a really dangerous situation.” Vaccination against pneumococci, which can cause pneumonia, was only temporarily possible. “I am very concerned about bottlenecks in vaccine delivery.” Demand increased significantly during the pandemic, and that is also expected for flu vaccines in the fall.

Especially at the beginning of the lockdown, it was unclear how delivery bottlenecks would develop, reports the Federal Association of Drug Manufacturers. Meanwhile, the supply situation in pharmacies and clinics has relaxed. “However, there is still the possibility of supply-related bottlenecks in the future,” said BAH CEO Hubertus Cranz.

If a manufacturer fails, it cannot be easily compensated

In principle, delivery problems are more likely if only a few suppliers make and sell a particular drug. Manufacturers in northern Italy and Spain were also affected by the crown lockdown for a short time, and imports of active ingredients from India and China were also restricted. Planning, production and delivery take an average of six months, Cranz explained. “The production of pharmaceutical products cannot be simply changed on demand.” If a manufacturer fails, there is no fixed compensation.

“If we only have one producer of a major active ingredient and it is somewhere where there is a blockage, then that is it,” explained Martin Schulz of the Federal Association of German Pharmacists Associations (ABDA). However, a delivery bottleneck does not always mean that patients can no longer be served. “It becomes a problem if, for example, a certain remedy is not available for some indications of cancer, then the delayed treatment can worsen the prognosis of the patient”, gives an example the expert.

There are currently more than 300 delivery bottleneck reports

According to the Federal Institute for Medicines and Medical Devices (BfArM), there are currently 317 reports of bottlenecks in deliveries (as of August 30). They affect 138 active ingredients, 87 of them are relevant for care, according to a spokesperson. According to Schulz, fewer and fewer essential medicines are produced in the EU. In recent years, a good 90 percent of antibiotics have been produced in East Asia.

In a new committee, drugs and substances for which to create stocks or increase quantities will now be determined, said Schulz, who is represented on the new advisory council. This is especially true for settings for which there are hardly any alternatives and which are necessary in intensive medicine. It is also about keeping as much as possible at least the manufacturers that are still in Europe.

There should be larger amounts for flu shots.

Focusing on a few producers also carries risks for vaccines. At the Paul Ehrlich Institute (PEI) it says: “If the number of vaccine manufacturers is still limited and if they turn to a few suppliers for individual vaccine components, it can be assumed that supply bottlenecks will continue to occur.” The good news: For flu vaccines, larger amounts will be available for the 2020/21 season than in previous years, and according to PEI’s forecast, this will be sufficient even if there is a higher fever.

To avoid supply problems despite bottlenecks in delivery, scarce funds can be allocated, that is, in limited quantities. As with acetaminophen, a fever-reducing pain reliever, in which it was temporarily strained, similar to toilet paper, because some were over-supplying. In some cases, doctors could also treat their patients with an alternative drug, Schulz said. “But of course that’s unpleasant and can always be a risk.”